| Evergreen Gardens Route 100 Waterbury Center, Vermont 05677 TOLL FREE PHONE # (800) 892-9716 |
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| Evergreen Gardens Route 100 Waterbury Center, Vermont 05677 TOLL FREE PHONE # (800) 892-9716 |
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| To order, phone us at (800) 892-9716 OR print this form, complete and fax to (802) 244-8523. |
| Name_______________________________________________________________________ |
| Address_____________________________________________________________________ |
| City_________________________________________State________Zip________________ |
| Phone_______________________________Email___________________________________ |
| Payment Method: _____Visa _____Mastercard _____Am.Express _____Discover |
| Credit Card#_________ _________ _________ _________Expiration date______/________ |
| Signature____________________________________________________________________ |
| Ship To (if different from billing address):
____________________________________ |
Gift Card to Read: ______________________________________ |
| Address:______________________________ | ___________________________________________ |
| _____________________________________ | ___________________________________________ |
| Phone: ______________________________ | ___________________________________________ |
| Item Name | Price | Qty. | Total |
| Vermont Traditions | $24.95 | _____ | $___________ |
| Custom Design | $24.95 | _____ | $___________ |
| Yankee Special | $21.95 | _____ | $___________ |
| SUBTOTAL | $___________ | ||
| SHIPPING | $ 7.95 | ||
| TAX (VT residents, add 5% tax) | $___________ | ||
| TOTAL | $___________ | ||
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